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dc.contributor.authorGowardman, John R
dc.contributor.authorRobertson, Iain K
dc.contributor.authorParkes, Scott
dc.contributor.authorRickard, Claire M
dc.contributor.editorDr. L Brochard (Editor-in-Chief)
dc.date.accessioned2017-05-03T15:25:00Z
dc.date.available2017-05-03T15:25:00Z
dc.date.issued2008
dc.date.modified2009-03-12T06:33:40Z
dc.identifier.issn0342-4642
dc.identifier.doi10.1007/s00134-008-1046-3
dc.identifier.urihttp://hdl.handle.net/10072/21668
dc.description.abstractObjective To compare colonization and catheter-related bloodstream infection (CR-BSI) rates among three insertion sites (subclavian, internal jugular, femoral) used for central venous catheter (CVC) placement. Design Twenty-four-month prospective study, with relative effects analyzed by Cox proportional hazards regression. Setting Eight-bed intensive care unit. Patients Four hundred and ten critically ill patients requiring CVC placement. Measurements and results All short-term multi-lumen CVCs, including antimicrobial-coated devices, were studied with management standardized. Six hundred and five CVCs (4,040 catheter days) were analyzed. Colonization and CR-BSI incidence were, respectively, 15.1 (95% CI 13.5-21.0) and 1.8 (95% CI 1.2-4.2) per 1,000 catheter-days. Colonization was higher at the internal jugular (HR 3.64; 95% CI 1.32-10.00; p?=?0.01) and femoral (HR 5.15; 95% CI 1.82-14.51; p?=?0.004) sites than at the subclavian site. The femoral site carried a greater risk of being colonized by non-S. epidermidis species than the subclavian and internal jugular sites combined (HR 4.15; 95% CI 1.79-9.61; p?=?0.001). CVCs inserted in the Department of Emergency Medicine were more colonized than those inserted in the ICU or operating room (HR 2.66; 95% CI 1.27-5.56; p?=?0.01), and CVCs were less colonized in females than in males (HR 0.49; 95% CI 0.26-0.89; p?=?0.02). No difference in CR-BSI rates was noted between the three sites. Conclusions Colonization was lowest at the subclavian site. Regional differences exist with respect to type of pathogen isolated. Colonization was influenced by insertion location and gender. The incidence of CR-BSI was not different.
dc.description.peerreviewedYes
dc.description.publicationstatusYes
dc.format.extent269409 bytes
dc.format.mimetypeapplication/pdf
dc.languageEnglish
dc.language.isoeng
dc.publisherSpringer Berlin
dc.publisher.placeGermany
dc.publisher.urihttp://www.springer.com/medicine/journal/134
dc.relation.ispartofstudentpublicationN
dc.relation.ispartofpagefrom1038
dc.relation.ispartofpageto1045
dc.relation.ispartofissue6
dc.relation.ispartofjournalIntensive Care Medicine
dc.relation.ispartofvolume34
dc.rights.retentionY
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchcode3202
dc.titleInfluence of insertion site on central venous catheter colonization and bloodstream infection rates
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
gro.facultyGriffith Health, School of Nursing and Midwifery
gro.rights.copyright© 2008 Springer-Verlag. This is the author-manuscript version of this paper. Reproduced in accordance with the copyright policy of the publisher. The original publication is available at www.springerlink.com
gro.date.issued2008
gro.hasfulltextFull Text
gro.griffith.authorRickard, Claire
gro.griffith.authorGowardman, John R.


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